FAMILY MEDICINE® COLUMN
By John C. Wolf, D.O.
Associate Professor of Family Medicine®
Ohio University College of Osteopathic Medicine

[LIMITING EXPOSURE AND USING SUNSCREEN KEYS TO SUNBURN-FREE SUMMER ]

Question: I was working outside the other day and managed to get a sunburn. It has peeled, and now I'm fine, but why does a sunburn hurt so much, and is a sunburn any different that any other type of burn?

Answer: The skin is the largest and, therefore, arguably the most important organ of the body. It protects us from injury and helps maintain the ideal environment for the body's cells. A sunburn is produced when sunlight damages the deeper growing layers of the skin. The resulting irritation to the skin, blood vessels, and associated tissue causes the inflammation we call a sunburn.

The skin is rich with nerve endings that keep us informed about the environment around us by allowing us to feel the size, shape and texture of everyday objects as well as sense temperature and pain. The pain of sunburn develops when these nerve cells are stimulated as part of the skin inflammation of a sunburn. Or, to put it in the venacular, "OUCH!" The label sunburn only tells that the damage came from being out in the sun, not the extent of the injury.

The health problems associated with burns are related to the amount of skin involved, the depth of burn, the individual's age and pre-existing health conditions (e.g, diabetes) that may be present. The specific cause of the burn the sun, boiling water, chemical injury or other cause is not important. The extent of skin damage is what counts.

Typically, a sunburn is painful with or without being touched. The sunburned look and discomfort improve after two or three days. The dead, damaged skin usually peels off in a week or two. This type of burn is referred to as a superficial, or first-degree, burn.

A second-degree burn produces damage deeper into the skin and can be very painful. Even air blowing across the burn can hurt. In addition to the pain, the skin will blister. Healing usually takes two or three weeks and a permanent mild scar or change in skin color may sometimes result.

A third-degree or "total-thickness burn" damages all the layers of skin. Touching a new third-degree burn with slight pressure may give some discomfort, but it's nothing like the sheer agony that this would produce if the burn was of the less severe, partial-thickness variety. Healing takes many weeks and always produces a scar.

As a general guideline, if your burn doesn't seem any worse than a mild sunburn, you can probably take care of it yourself. Protect the skin stay out of the sun and take aspirin, acetaminophen or ibuprofen for the discomfort. Don't put butter or other gooey substances on the burn. There are several non-prescription sunburn lotions and sprays that are soothing, but they will not hasten the healing of damaged skin.

If you feel sick because of the burn, or if it covers a large percentage of your body, you should see your doctor. More severe burns with immediate blistering or blackening of the skin should have a doctor's attention today don't wait until next week. Deep burns over a large amount of the body surface can be immediately life threatening and require prompt hospitalization.

Here are two tips that will help keep you from having to deal with the pain of sunburn this summer:

- Avoid being outdoors during the hours of the day when the sun's rays are the most direct between about 10 a.m. and 2 p.m.

- When you go outside during the day, protect your skin with clothing or by putting a number 15, or higher, sunscreen lotion on the exposed areas of your body.

Some studies suggest that 2000-mg of vitamin C a day or use of vitamin E will reduce the risk of sunburn. That seems like a safe and inexpensive additional precaution to take, too.

Family Medicine® is a weekly column. To submit questions, write to John C. Wolf, D.O., Ohio University College of Osteopathic Medicine, Grosvenor Hall, Athens, Ohio 45701.